Ileostomy using an interposed ileal segment to function as a ‘neocolon’

Abstract

A new type of ileostomy was constructed in rats using an interposed ileal (I-I) segment functioning as a neocolon. The effects of this operation in these rats were compared with a control group undergoing conventional ileostomy (I). Rats in the I group lost weight throughout follow-up, whereas rats in the I-I group regained weight and were significantly heavier four weeks after surgery. Transit time from the stomach to the stoma was significantly prolonged in the I-I group (187 +/- 29 minutes) when compared with the I group (141 +/- 17 minutes, P less than 0.01). Serum analysis revealed no significant differences in total protein, lipids, electrolytes (Na, Cl, CO2), and osmolarity between the groups. Biliary bile salt concentration, normalized bile flow, and normalized bile acid output in the I-I group were not different from those in unoperated control rats, suggesting unimpaired bile acid metabolism. These data suggest this operative procedure has the beneficial effects of slowing intestinal transit and promoting postoperative recovery without impairing distal ileal function.

Morphology following Proctocolectomy in Dogs: Effect of Introduction of a ‘Neocolon’ Using an Interposed Jejunal Segment

“…This is the most important advantage of our procedure. The procedure may also have the beneficial effect of slowing gastrointestinal transit time, preserving enterohepatic circulation of bile acids and promotion of postoperative recov ery, as also shown for the recently reported new ileostomy procedure [26],…”

Effect of Terminal Ileal Transposition on Gallbladder Bile Composition Following Proctocolectomy

“…the IAA group following proctocolectomy. No signifi-Nakahara et al [29] have demonstrated that the trancant differences in the cholesterol saturation index or sit time from mouth to stoma is prolonged by interposthe concentrations of phospholipid and cholesterol in ing a proximal ileal segment between the terminal ilthe gallbladder bile existed between the groups. eum and the stoma in rats following ileostomy.…”